Lawmakers question private-option enrollment methods

Thursday

Nov 21, 2013 at 8:25 AM

LITTLE ROCK — The methods that state officials are using to enroll some people in the state’s expanded Medicaid program came under fire Thursday from some state legislators who questioned whether individual choice was being bypassed.

LITTLE ROCK — The methods that state officials are using to enroll some people in the state’s expanded Medicaid program came under fire Thursday from some state legislators who questioned whether individual choice was being bypassed.

The state’s top medical official countered that the methods are designed to make the program succeed and said some people want the program to fail.

About 63,000 people have enrolled, most of them in the so-called "private option," the state’s plan for using federal Medicaid money to subsidize private insurance for low-income workers. State Medicaid Director Andy Allison told the House and Senate committees on public health, welfare and labor Thursday that about 47,500 of those people have been automatically assigned plans after they indicated that wanted to enroll but failed to choose a plan within 12 days.

People who are automatically assigned a plan have 30 days to decide whether to keep it or choose another plan.

"When the P.O. bill was debated, there was nothing mentioned about auto-assignment, auto-enrollment," Sen. Bryan King, R-Green Forest, said during Thursday’s hearing. "We were consistently told that these people would have what we call ‘skin in the game’ (and) they were going to be making their own decisions."

Rep. Justin Harris, R-West Fork, also questioned the auto-assignment practice, saying, "We wanted more personal responsibility. That’s what the private option in the bill talked about, and this has no personal responsibility."

Allison said the auto-assignment practice is intended to prevent administrative complexity from being a barrier to obtaining insurance. He said the private option does require personal responsibility, noting that participants will have to bear a portion of the expense of their medical care.

King also objected to the method that the Department of Human Services used to reach out to participants in the Supplemental Nutritional Assistance Program. DHS sent letters to 145,000 adult participants in the program whom it had determined were eligible for the private option, and about 63,000 responded that they wanted to enroll.

"If you send out so many thousand letters saying, ‘You basically have got free health care, just send this back in,’ well that’s such a leader that they’re going to send that back in. It’s almost like saying, ‘You get a free car,’" King said.

State Surgeon General Joe Thompson said there was "a fundamental issue" that ought to be put on the table.

"The success or failure of the private option, the success or failure of the private (health insurance) marketplace, is directly dependent on how many people get enrolled," he said. "People who want there to be fewer, they don’t want that success to happen. For people who want there to be more, they want that success to happen."

Harris objected to Thompson’s comment.

"I think our questions are very respectful, and we want the answers," he said. "I don’t appreciate you as the surgeon general saying that that’s blocking the program."

Harris was continuing along those lines when Rep. John Burris, R-Harrison, chairman of the House public health committee, interrupted and said, "Can we just say ‘Noted,’ in the interest of time?’"

"Yes, Rep. Burris, but you weren’t in here when it happened," Harris shot back. "I want to be noted and get my statement out there instead of you cutting me off every time I say something."

Burris was one of the architects and proponents of the private option during this year’s legislative session. King and Harris voted against the plan.

At King’s request, the Legislative Joint Auditing Committee recently ordered an audit of the private option. King has said he wants auditors to look at the auto-assignment process during the audit.

Some Republican legislators have said they will push for defunding the private option during next year’s fiscal session, which begins in February.

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